POS1247 RIGHT VENTRICULAR MORPHOLOGY AND FUNCTION AFTER HIGH INTENSITY INTERVAL AND RESISTANCE TRAINING IN PEOPLE WITH SYSTEMIC SCLEROSIS: A RANDOMISED CONTROLLED PILOT STUDY
Authors: A. Mitropoulos, T. Dimitroulas, M. Anifanti, E. Triantafyllidou, A. Teloudi, N. Sirakou, E. Pagkopoulou, C. Boström, L. P. Diederichsen, G. Cuomo, M. Klonizakis, E. Kouidi
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The presence of left ventricular (LV) remodeling and dysfunction in systemic sclerosis (SSc) have been well studied to date [1]. Cardiac deformation and impaired right ventricular (RV) free wall contractility patterns in SSc have also been described [2]. High intensity interval training (HIIT) has demonstrated to improve microvascular function in people with SSc [3]. However, the cardiac morphology and function after exercise training in people with SSc have not been studied yet. Echocardiographic indices of RV function [4] were found to be correlated with cardiorespiratory fitness, as assessed by peak oxygen uptake (VO<sub>2</sub>peak) in people with SSc. <h3>Objectives</h3> The primary objective of the present study was to assess possible exercise-induced changes in RV morphology and function. A secondary objective was to explore the relationship between VO<sub>2</sub> peak and RV echocardiographic indices after exercise training in people with SSc. <h3>Methods</h3> Twenty-eight people with SSc (24 females, mean age 57.21 ± 10.76 yrs.) were randomized into groups A (exercise) and B (control group). Baseline and three-month follow up assessments included: medical history, anthropometrics, echocardiography, and an arm crank cardiopulmonary exercise testing (CPET). Following the baseline assessments, Group A performed a 3-month supervised exercise program (twice/week) adjunctive to the usual care, while Group B received only the usual care. The supervised exercise training consisted of aerobic and resistance exercises as described previously [5]. The aerobic protocol consisted of HIIT (30s at 100% of peak power output achieved during CPET following by 30s passive recovery) on an arm ergometer. <h3>Results</h3> The average compliance in the exercise program was 90% with no dropouts and no adverse effects. Group A demonstrated a statistically significant increase in VO<sub>2</sub> peak by 25.1% (p&lt;0.001), global RV free wall longitudinal systolic strain by 6.69% (p&lt;0.03), RV free wall longitudinal systolic strain of the basal segment by 13.5% (p&lt;0.001) and global RV four-chamber longitudinal systolic strain by 6.76% (p&lt;0.03) after exercise training (Figure 1). No statistically significant difference was observed in group B. <h3>Conclusion</h3> Our results support the significance of 2DSTE in clinical practice for the early detection of cardiac deformation in SSc patients. In conclusion, a combined exercise training program seems to be effective in improving cardiorespiratory efficiency and RV systolic function in people with SSc with subclinical RV dysfunction. <h3>References</h3> [1]Giucă, A.; Gegenava, T.; Mihai, C.M.; Jurcuţ, C.; Săftoiu, A.; Gȋrniţă, D.M.; Popescu, B.A.; Marsan, N.A.; Jurcuț, R. Sclerodermic Cardiomyopathy-A State-of-the-Art Review. <i>Diagnostics (Basel).</i><b>2022,</b> 9;12(3):669. [2]Mukherjee, M.; Chung, S.E.; Ton, V.K.; Tedford, R.J.; Hummers, L.K.; Wigley, F.M.; Abraham, T.P.; Shah, A.A. Unique abnormalities in right ventricular longitudinal strain in systemic sclerosis patients. <i>Circ Cardiovasc Imaging.</i><b>2016</b>, 9(6):10. [3]Mitropoulos A, Gumber A, Crank H, Akil M, Klonizakis M. The effects of upper and lower limb exercise on the microvascular reactivity in limited cutaneous systemic sclerosis patients. <i>Arthritis Res Ther.</i><b>2018</b>; 20(1):112. [4]Colalillo, A.; Pellicano, C.; Romaniello, A.; Rosato, E. In systemic sclerosis TAPSE/sPAP ratio is correlated with ventilatory efficiency and exercise capacity assessed by CPET. <i>Clin Exp Med.</i><b>2022</b>,12. doi: 10.1007/s10238-022-00804-5. [5]Mitropoulos, A.; Gumber, A.; Akil, M.; Klonizakis, M. Exploring the microcirculatory effects of an exercise programme including aerobic and resistance training in people with limited cutaneous systemic sclerosis. <i>Microvasc Res.</i><b>2019</b>, 125:103887. <h3> Acknowledgements</h3> The authors would like to thank the study patients that volunteered to take part in the study. <h3>Disclosure of Interests</h3> None Declared.